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P59Prenatal diagnosis of fetal rubella infection by ultrasound‐guided cordocentesis
Author(s) -
Park J. S.,
Roh J. W.,
Moon J. B.,
Jun J. K.,
Yoon B. H.,
Moon S. Y.,
Syn H. C.,
Lee H. P.
Publication year - 2000
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1046/j.1469-0705.2000.00004-1-59.x
Subject(s) - medicine , rubella , congenital rubella syndrome , rubella virus , obstetrics , pregnancy , fetus , prenatal diagnosis , cord blood , amniotic fluid , immunology , measles , vaccination , biology , genetics
Objective Our purpose was to compare the accuracy between rubella‐specific IgM and polymerase chain reaction (PCR) for the diagnosis of fetal rubella infection by ultrasound‐guided cordocentesis. Method 30 pregnant women with the evidences of rubella infection were enrolled. Fetal rubella infection was diagnosed by rubella‐specific IgM using microparticle enzyme immunoassay (MEIA) and rubella virus PCR with the blood obtained by ultrasound‐guided cordocentesis after 21 weeks of gestation. Neonatal outcomes were evaluated by physical examination at birth and rubella‐specific IgM if possible. Results 20 cases were evaluated by IgM and PCR, and 10 cases only IgM. No fetus showed positive IgM antibody, and 8 of 20 cases showed positive PCR in cord blood, and 6 in amniotic fluid. One infant with negative rubella‐specific IgM by cordocentesis before completed 22 weeks resulted in positive IgM at birth, low birth weight, strabismus and developmental delay. These findings were compatible with congenital rubella syndrome. No case showed congenital rubella syndrome in the fetuses with positive rubella PCR. Conclusion (1) The incidence of fetal rubella infection may be very low in mothers with rubella infection. It is suggested that prenatal diagnosis should be performed even if maternal infection occurs in early pregnancy; (2) Cord blood rubella‐specific IgM is more accurate than PCR for the prenatal diagnosis of congenital rubella syndrome; (3) Cordocentesis for rubella‐specific IgM detection should be done after 22 weeks of gestation for accurate diagnosis.